Request an Appointment at Quigley Eye Specialists

Please fill out the form to request an appointment. You will be contacted within 1 business day to confirm availability. For immediate concerns or emergencies, please call 855-734-2020.

The Q Laser & Med Spa

LASIK Candidate Quiz.

1. What is your age?

2. Are you currently wearing...? (Please check all that apply)

3. What best describes your reason for corrective lenses? (Please check all that apply)

4. Have you been told you have...? (Please check all that apply)

5. Have you had a stable prescription or has your vision been stable for at least a year?

6. Do you know your prescription?

7. Are you currently nursing or pregnant?

8. What are your primary concerns with LASIK? (Please check all that apply)

9. Have you ever had an eye injury or eye surgery?

10. Would you like to be contacted to schedule a LASIK screening?

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